Details

Autor(en) / Beteiligte

• Masa, Juan F
• Mokhlesi, Babak
• Benítez, Iván
• Gómez de Terreros Caro, Francisco Javier
• Sánchez-Quiroga, M-Ángeles
• Romero, Auxiliadora
• Caballero, Candela
• Alonso-Álvarez, Maria Luz
• Ordax-Carbajo, Estrella
• Gómez-García, Teresa
• González, Mónica
• López-Martín, Soledad
• Marin, Jose M
• Martí, Sergi
• Díaz-Cambriles, Trinidad
• Chiner, Eusebi
• Egea, Carlos
• Barca, Javier
• Vázquez-Polo, Francisco-José
• Negrín, Miguel Angel
• Martel-Escobar, María
• Barbé, Ferran
• Corral-Peñafiel, Jaime
• Gomez de Terreros, Francisco Javier
• Sánchez-Quiroga, Maria Ángeles
• Caballero-Eraso Estrella Ordax, Candela
• Troncoso, Maria F
• Marin, José M
• Negrín, Miguel A
• Barbe, Ferran
• Corral, Jaime
• Utrabo, Isabel
• Gonzalez-Mangado, Nicolas
• F Troncoso, María
• Martinez-Martinez, M-Ángeles
• Castillejo, Elena Ojeda
• López-Padilla, Daniel
• Carrizo, Santiago
• Gallego, Begoña
• Pallero, Mercedes
• Romero, Odile
• Ramon, Maria A
• Arias, Eva
• Méndez, Jesús Muñoz
• Cristina, Senent
• Sancho-Chust, Jose N
• Navarro-Soriano, Nieves Belén
• Cabrero, Jaime Marcos
• Sanchez Gomez, Jesus Fernando
• Golpe, Rafael
• Gomez Mendieta, M Antonia
• Gomez, Silvia
• Bengoa, Mónica

Titel

Cost-effectiveness of positive airway pressure modalities in obesity hypoventilation syndrome with severe obstructive sleep apnoea

Ist Teil von

• Thorax, 2020-06, Vol.75 (6), p.459-467

Ort / Verlag

England: BMJ Publishing Group Ltd and British Thoracic Society

Erscheinungsjahr

2020

Beschreibungen/Notizen

• BackgroundObesity hypoventilation syndrome (OHS) is treated with either non-invasive ventilation (NIV) or CPAP, but there are no long-term cost-effectiveness studies comparing the two treatment modalities.ObjectivesWe performed a large, multicentre, randomised, open-label controlled study to determine the comparative long-term cost and effectiveness of NIV versus CPAP in patients with OHS with severe obstructive sleep apnoea (OSA) using hospitalisation days as the primary outcome measure.MethodsHospital resource utilisation and within trial costs were evaluated against the difference in effectiveness based on the primary outcome (hospitalisation days/year, transformed and non-transformed in monetary term). Costs and effectiveness were estimated from a log-normal distribution using a Bayesian approach. A secondary analysis by adherence subgroups was performed.ResultsIn total, 363 patients were selected, 215 were randomised and 202 were available for the analysis. The median (IQR) follow-up was 3.01 (2.91–3.14) years for NIV group and 3.00 (2.92–3.17) years for CPAP. The mean (SD) Bayesian estimated hospital days was 2.13 (0.73) for CPAP and 1.89 (0.78) for NIV. The mean (SD) Bayesian estimated cost per patient/year in the NIV arm, excluding hospitalisation costs, was €2075.98 (91.6), which was higher than the cost in the CPAP arm of €1219.06 (52.3); mean difference €857.6 (105.5). CPAP was more cost-effective than NIV (99.5% probability) because longer hospital stay in the CPAP arm was compensated for by its lower costs. Similar findings were observed in the high and low adherence subgroups.ConclusionCPAP is more cost-effective than NIV; therefore, CPAP should be the preferred treatment for patients with OHS with severe OSA.Trial registration number NCT01405976